Do you have difficulty sleeping or concentrating? Have you lost your appetite or interest in pleasurable activities? Are you sad most of the time? If so, you may be depressed.

The Mind/Body Health Newsletter reports that depression is more common than coronary artery disease, cancer or AIDS. It causes greater day-to-day impairment in quality of life than diabetes, high blood pressure, arthritis or ulcers.

Depression costs industrialized countries several billion each year in treatments, absenteeism, and lost productivity and wages. It's estimated that by 2020, depressive illnesses will become the leading cause of disease in developed countries.

Many factors contribute to depression including genetics, poor diet and sleep habits, and food sensitivity. Illnesses and their treatments, drug interactions, improper metabolism and social isolation are other causes.

A family history of depression suggests biological vulnerability. Psychological makeup plays a role. Pessimistic, dependent people with low confidence who are easily overwhelmed by stress, are prone to depression. A major loss (death of a loved one, job termination) and work stress are also linked to depression.

Symptoms of DepressionThe Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) lists the following criteria for major depression. At least five must be present every day during the same two-week period. Do any of these apply to you?

- Depressed mood most of the day.
- Diminished interest or pleasure in most activities.
- Reduced or increased appetite.
- Insomnia or excessive sleeping.
- Extreme restlessness or lethargy.
- Fatigue or loss of energy.
- Feelings of worthlessness, guilt, hopelessness or pessimism.
- Diminished ability to think, concentrate or make decisions.
- Recurrent thoughts of death or suicide.
- Irritability or excessive crying.

Although five of the foregoing suggest severe depression, take action if you checked any criterion.

Tips for managing depression
- Seek professional assistance. Getting help is not a sign of weakness. Mental and medical health specialists, who practice in community health centers, hospitals, company EAP programs and private offices, offer evaluation and treatment.

Get a thorough medical examination to rule out health causes. If you have severe or chronic depression caused by a chemical imbalance, medications will be prescribed to alter brain chemical action and improve mood, sleep, appetite, energy level and concentration.

Talking with a trained counselor or psychologist can be effective in treating less severe or non chronic depression. Therapy can be helpful alone or used in combination with medication.

Sometimes, it is helpful to discuss certain work problems with a supervisor or co-workers. Focus on improving the situations, not personalities, and end talks on a positive note.

- Recognize and change negative thoughts and behaviors. Negative thoughts are often unrealistic, and tend to have a generalized, exaggerated, spiraling quality.

You are what you think. You can choose to dwell on and enlarge mistakes or hurtful feelings which will contribute to depression. Or, you can stop negative thoughts and replace these with more positive, constructive ones.

If your supervisor suggests changing part of a report, you can think, "I made another mistake. I'm useless . . ." Or, you can monitor negative thoughts, note whether you made similar mistakes before, and replace the irrational, negative belief with a more positive statement. "I haven't made this mistake before. . . Now I really know how to improve my reports . . ."

Focus on opportunities, constructive ways of dealing with challenges. Practice positive self-talk. Emotionally believe you can control situations. Listen to motivational quotes during your commute.

Don't take customer complaints personally. You're usually the outlet for their anger and frustration with the company policies, services or products.

- Enhance confidence. Prepare a list of accomplishments and positive personality characteristics. Post this where you can read it daily. Build on accomplishments. Each day, enhance some previous performance.

Think and talk about things you want. Review fortunate experiences in a journal. Note the role belief and hard work played in achieving successes as well as strategies used.

Participate in activities that give pleasure and a sense of accomplishment. Plan enjoyable activities daily. Watch a movie, get a massage, take a class on a topic of interest, join a hiking group.

- Develop meaningful relationships. Associate with positive, supportive people who believe in your abilities. Help others as well as yourself by volunteering for a cause in which you believe.

Join a support group. You may be surprised to learn an evening with a group of depressed people can be enjoyable. Support groups provide a forum for mutual acceptance, understanding and self-discovery.

- Safeguard health. Keep a journal to chart eating and sleeping habits, and enjoyable and stressful activities. Identify factors that may be contributing to depression, and replace these with more positive ones.
Minimize stress by exercising, meditating, engaging in hobbies, and creating a relaxing morning routine. Don't take work problems home.